Open reduction nasal fracture?

Question

I consulted with a plastic surgeon to undergo a septoplasty with turbinate reduction, as well as "open reduction nasal fracture". Externally, my nose is slightly displaced to one side, so he said the ORNF would help that appear straighter- is that a fracturing of the bone or just the septum? If it is a breaking of the bone, would having minuscule dorsal hump removed at the same time be difficult/ time consuming (leading to large out of pocket expenses because its cosmetic)?

William Portuese, MD · Answer

An open reduction nasal fracture involves osteotomies placed in the nasal bones to reduce  and straighten the  crooked nasal bones.  The open reduction nasal fracture involves making 2 small incisions on the inside of the nose to accomplish the reduction. Remember, there must be a medical necessity documented for this procedure to be billed to medical insurance, otherwise its cosmetic surgery. A septoplasty and turbinate reduction are performed to improve air flow through the nose and will have no bearing on the shape of the nose. The open reduction nasal fracture does involve making osteotomies in the nasal bones  and resetting them straight. Best to talk with your rhinoplasty surgeon about hump removal as well, since that is also cosmetic. For more information about the differences between a functional septoplasty and a  cosmetic rhinoplasty, please see the video and link below

Shaun C. Desai, MD, FACS · Answer

If the external nose is crooked and an "open reduction" was mentioned that is considered a rhinoplasty as you are changing the external appearance of the nose by breaking the nasal bones. Taking down a dorsal hump in that setting is not difficult and very commonly performed in the same setting as septoplasty and other external bony work for functional breathing concerns. Taking down the dorsal hump is cosmetic but usually can be done for a reasonable cosmetic charge as this does not take very long and not very hard to do. I would recommend going to a facial plastic/ plastic surgeon who has significant experience in both functional nasal airway surgery (septoplasty and nasal valve repair) as well as cosmetic rhinoplasty. Hope this helps and good luck!

Open reduction nasal fracture?

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